MSRA: Overdose + Antidotes

Question 1

Paracetamol

Answer 1

1hr - Activated charcoal
NAC

Question 2

Carbon Monoxide

Answer 2

100% Oxygen

Question 3

Salicylates (Aspirin)

Answer 3

Urinary alkalinisation with IV bicarb

Haemodialysis

Question 4

Opioids

Answer 4

Naloxone

Question 5

Digoxin

Answer 5

Digoxin specific antibody

Question 6

Benzodiazepines

Answer 6

Flumazenil

Question 7

Cyanide

Answer 7

Hydroxycobalamime

Question 8

Tricyclic Antidepressants

Answer 8

IV Bicarbonate

Question 9

Lithium

Answer 9

Haemodialysis

Question 10

Warfarin

Answer 10

Vitamin K

Prothrombin

Question 11

Heparin (UF)

Answer 11

Protamine sulphate

Question 12

B-blockers

Answer 12

Atropine, then Glucagon

Question 13

Organophoshates

Answer 13

Atropine

Question 14

Anti-freeze (ethylene glycol)

Answer 14

Fomepizole

Question 15

Methanol

Answer 15

Fomepizole/Ethanol

Question 16

Iron

Answer 16

Desferrioxamine

Question 17

Lead

Answer 17

Dimercaprol/Calcium Edetate

Question 18

What are the indications for starting NAC?

Answer 18

Staggered overdose (taken over more than 1 hour)
Serum levels above treatment line at 4 hours
Presents between 8-24 hours and taken more than 150mg/kg

Question 19

What are the features of carbon monoxide poisioning?

Answer 19

Headache **
Nausea, vomiting
Vertigo
In severe cases: Deep flushed cherry red skin, hyperpyrexia

Question 20

What are the symptoms in TCA overdose?

Answer 20

Tachycardia
Sweating
Reduced GCS

Question 21

What are the ECG changes in TCA overdose?

Answer 21

Sinus tachycardia
Widened QRS
Prolonged QT